Talk:Methocarbamol

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what happens if you take Robaxin for no reason?

Your muscles will still relax and you'll want to lie down for a while. --Zeromaru[[User_talk:Zeromaru|^T]][[Special:Contributions/Zeromaru|^C]] 04:51, 8 December 2005 (UTC)

Erowid is a good source (with a large grain of salt) for drug info & personal experience outside of medical practice. It doesn't have much on methocarbamol, though: www.erowid.org/experiences/subs/exp_Methocarbamol.shtml --D Anthony Patriarche (talk) 01:41, 12 May 2018 (UTC)

I should add just to clarify that Erowid is not an acceptable source for Wikipedia medical & drug articles as its content is mostly submitted by lay users and is not subject to professional peer review. Even content drawn from reputable sources may be out of date or misleading. --D Anthony Patriarche (talk) 15:30, 11 August 2019 (UTC)

User:share- Methocarbamol is a muscle relaxant that exerts its effect by acting on the central nervous system (ie the nerves that control the muscles) rather than on the muscles themselves. Methocarbamol can be used in any condition where painful muscle spasms should be reduced for patient comfort (intervertebral disc disease, for example) but it is also considered the treatment of choice for metaldehyde (snail bait) poisoning, a condition causing severe muscle twitching. Methocarbamol is also used in the treatment of tetanus (which is characterized by muscle rigidity) and strichnine poisoning (characterized by stiffness and seizuring). In cats, methocarbamol is an important medication in the treatment of permethrin poisoning (which occurs when canine permethrin flea products are used inadvertantly on pet cats.)

An oral dose of methocarbamol is active in the body approximately 30 minutes after administration with activity peaking in 2 hours (in humans).

Could this be added to the article? - Eagle^amn 22:04, 12 February 2006 (UTC)

For high-notability articles (e.g. diazepam), this would go in a separate Pharmacology section. Methocarbamol doesn't seem to be that notable in the WP sense, despite its commonplace use. I'm looking into updating the drugbox, which IMO would be the right place for such info in an short article such as this. --D Anthony Patriarche (talk) 01:41, 12 May 2018 (UTC)

Hi, I added a clarification to the trade names, since here in Spain Robaxisal refers to the Methocarbamol/Paracetamol combination, not to the aspirin one. I forgot to explain the edit so I'll just leave this here. Walenzack (talk) —Preceding undated comment added 09:01, 18 October 2012 (UTC)

Methocarbamol and breastfeeding

Pregnancy Risk C Lactation Risk C Adult dosage 4-4.5g q 4-6 hours. T1/2 = 0.9 - 1.8 hours Peak - 1-2 hours Approved by the American Academy of Pedriatrics for use in breastfeeding mothers.

References Parmacceutical Manufacturers Package Insert, 1995

Hale. Thomas Ph.D Medication and Mothers' Milk 2000'Italic text

I use this to control the muscle spasms that i suffer as a result of Fibromyalgia and Chronic Fatigue Syndrome.

Hope this helps.

HB —Preceding unsigned comment added by 88.110.1.61 (talk) 23:10, 17 February 2008 (UTC) best medication for back pain

Dosage and prescription information section

This section is incomplete, and contains some erroneous information. It appears that this section was cut and pasted from another source (though it has no reference information) as it contains references to sections that do not exist within the article. This section appears to have been copied from information referring to the injectable dosage form only. As a result, the first line of the section, "For Intravenous and Intramuscular Use Only.", is misleading. Robaxin (methocarbamol) is also available as an oral tablet available in 500mg and 750mg strengths. In addition, methocarbamol is also available in tablets that also contain ASA, APAP, and IBU (I do not have those strengths in front of me at the moment). I will gather that information sometime in the next few days and post it here, or will consider rewriting the "Dosage and Prescription Information" section. I am entirely new to this process, so please, let me know if I have done anything incorrectly or not according to custom.

EazyCure (talk) 06:11, 22 June 2009 (UTC)

My understanding is that current WP policy is not to include dosage and prescription information. The section was removed Aug 1, 2009. --D Anthony Patriarche (talk) 02:24, 12 May 2018 (UTC)  Done

state of this article

Honestly, this article right now is kind of terrible.

The grammar is awful and a lot of it reeks of copy-pasting from somewhere else, nor is it written in the proper style at all.

I would try to fix this, but it's not something I really know much about myself. 68.0.245.146 (talk) 05:45, 26 July 2009 (UTC)

I've tagged the article as needing reorganization. I'm not qualified to judge the accuracy of the information contained in the article but I can vouch for the fact that it is entirely unreadable. Ahugenerd (talk) 00:34, 2 August 2009 (UTC)

I cleaned it up. There was a large piece of text there which I think was copied from somewhere else. After removal the article is fine, maybe a bit stubby. --Dirk Beetstra ^{T C} 00:43, 2 August 2009 (UTC)

It says nowhere what classification this drug falls into - is it a Narcotic? —Preceding unsigned comment added by CaptBillWilson (talk • contribs) 17:38, 11 February 2010 (UTC)

I don't believe it's narcotic. They sell it OTC in Canada and it's reported not to have any significant recreational use. —Preceding unsigned comment added by 69.63.54.165 (talk) 18:54, 26 February 2010 (UTC)

Depend's on what your definition or a narcotic is. To me, a narcotic is anything that slows down brain function. As this drug acts on the central nervous system, it does have potential for a recreational high. However, in Canada, it is always mixed with Acetaminophen or Ibuprofen when sold OTC. — ク Eloc 貢 21:35, 6 August 2012 (UTC)

—slight correction (definition of OTC?): in Canada (BC for certain) it is sold combined with acetaminophen, ibuprofen or ASA on open shelves but a pharmacist must be on duty. Pure methocarbamol (Robaxin & Robaxin 750) is sold OTC, that is you can purchase it literally over-the-counter from the pharmacist. D Anthony Patriarche (talk) 22:38, 11 May 2018 (UTC)

Not a narcotic legally, and probably would not be considered a narcotic medically, although a large dose (3 g) will lead to sleep in most people (Original Research). Note that it is somewhat related to meprobamate, which is not a narcotic but is Schedule IV in Canada & US and is no longer in common use due mainly to addiction risk (also OR). Classification is difficult (other than "muscle relaxant") as the mechanism of action is uncertain. It shares some properties with the benzodiazepines and appears to exert its action at least in part via the GABA receptor as they do, but the mechanism is different (more OR, I'm afraid). --D Anthony Patriarche (talk) 00:05, 12 May 2018 (UTC)

Confusing section

I've removed this section from the article because it is not very clear. For example, what is methocarbamol being compared to? Also, is it even worth including a 40 year old study? There isn't anything more recent? -- Ed (Edgar181) 12:10, 22 December 2012 (UTC)

In a comparative study by Tisdale comparing activity of Skeletal Muscle Relaxant found that, in Acute local muscle spasm Methocarbamol is superior for muscle spasm and local pain at 48 hours using 5-point scales;(P _ 0.05) but not for local pain (P _ 0.10) using 5-point scales (Tisdale SAJ, Ervin DK. A controlled study of methocarbamol (Robaxin) in acute painful musculoskeletal conditions. Curr Ther Res Clin Exp 1975;17(6):525–530.)

Just a comment--article seems mostly useless to me

  The drug combinations etc are interesting, but the useful stuff would be about the practical effects on the muscles.  I have low back pain, I'm told from tight muscles, and lately I'm also getting painful tightness in leg muscles.  I exercise a lot, so I need to know what exactly happens to the muscles, and what will that do while I'm doing various kinds of exercise.   I have only taken it a few times, have not really felt any great effect, but am reluctant to take it other than at bedtime since I don't know whether the relaxing effect might make it easier to strain muscles when I'm dancing,doing yoga, etc.   
  Please add stuff about what happens to muscles and what their capacities are then.   
thank you,  Rosa-lyn Householder  — Preceding unsigned comment added by 174.29.134.163 (talk) 15:05, 28 July 2013 (UTC) 

Frankly, wish we knew! All sources I have reviewed say no direct effect on muscles, it acts centrally, i.e. it's a sort of sedative, but the exact mechanism is unknown. I believe this drug suffers from having been developed under the shadow of much more glamorous and popular drugs, e.g. Miltown (Meprobamate), immortalized by T S Eliot in The Cocktail Party, with which methocarbamol shares some structural similarities; having been developed over 50 years ago, nobody seems to be much interested in researching its means of action. Ironically, meprobamate is now almost never prescribed — in fact is unavailable — in most countries, while methocarbamol trudges on. --D Anthony Patriarche (talk) 06:59, 30 July 2019 (UTC)

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Marketing - cost

I really don't think something as ephemeral and variable as cost for a "typical month" belongs in an encyclopedia article. At what dose? Generic or Brand Name? Pure methocarbamol or compound? US, Canada, UK or ??? A month of Robaxin® at a moderately high dose may cost $250 CAD (2018), not $25. For now I've moved this from the article header to Marketing, but IMO it would be better deleted. Comments? --D Anthony Patriarche (talk) 01:24, 12 May 2018 (UTC)

The third para of the lead is a mish-mash; the second sentence appears to refer to the US but the cite is the British pharmacopaeia; '187th most prescribed in US' is not all that informative, particularly when it is available OTC in may countries and probably sells an order of magnitude more doses; and the information is not supported with detail in the body, so it doesn't belong in the lead as I understand WP policy. If no-one objects in the next day or so I will delete most of this paragraph and move the approval date into the body (Marketing). --D Anthony Patriarche (talk) 07:10, 30 July 2019 (UTC)

I see this information is becoming standard in the lead for pharmaceutical articles. I guess consistency across articles trumps my opinion as an editor! And I'm OK with that up to a point. Someone comparing these figures from many articles can get a rough feel for comparative cost of drugs. So I won't monkey with the final para of the lead here, except perhaps to clarify US/UK/government cites, since further changes would need to be systemic.

Nevertheless, I still maintain this information is implicitly almost meaningless without more quantification and qualification. In this one case, the US "wholesale" cost given in the article, derived from the table in reference data.medicaid.gov–NADAC, appears to be based on a purely nominal quantity: 100 500-mg tablets per month (the NADAC table has 0.06526/tab). First, this is not really a "wholesale" cost in the common sense of the word: NADAC is National Average Drug Acquisition Cost for the entire US Medicaid program buying in enormous quantities. Moreover, Drugs.com gives an average/recommended maintenance dose for muscle spasm of q.240-270 500-mg tabs/month (4000-4500 mg x 30 days) and up to q.480/month in severe cases, not q.100/month. And of course the NADAC figure of $0.065/tab is the cost to government in huge quantities (10,000 up to 100,000 or even 500,000 per "package" (!), if I am reading the related table correctly). One more niggle: I couldn't find any mention in the US reference cited of a "month supply", so unless I missed an ancillary table in that ref, I would have to conclude the calculation, however simple, is OR, or at least WP:SYNTH from source(s) not cited. Furthermore, it's my understanding that WP policy is that all statements in the lead must first appear in the body with more detail if appropriate & of course full cites (cites being deprecated in the lead). And finally, as I said above, the figures are necessarily ephemeral, requiring frequent updating, and in IMO for this reason not appropriate in the lead, which should be stable in a mature article.

The devil is in the details. The NADAC cost is orders of magnitude different from consumer prices, prescribed or OTC, typically 50 - 100 times this "wholesale" figure. Actual wholesalers, who sell to primary retailers, i.e. pharmacies, also have a much higher price: Just for comparison, in Canada Robaxin (branded) 750 mg currently retails OTC for roughly $1.50 CAD ($1.13 USD) per tab; the wholesale price to a typical pharmacy is about $0.80 CAD/tab, I reckon about $.60/tab to a large outlet such as Walmart. An actual prescription in my jurisdiction would be based on wholesale plus professional fee (~$10). OTC generic formulations with ibuprofen or acetaminophen are generally cheaper, e.g. $0.40-.65 CAD for the 500 mg formulation with ibuprofen, quantity 40-100. For comparison, the US online retail cost for generic methocarbamol 750-mg (not available in Canada) ranges from about $0.20 to $0.40 USD per tablet in a quick check. Surely it is the retail cost that is of most interest to 99 out of 100 people reading this article. And in that regard, the cost quoted, even though qualified as "wholesale", is IMO highly misleading.

I would suggest the US figures, at least, should be desribed correctly as government Medicaid purchase cost, not "wholesale". I don't have access to the UK refernce cited, BNF-76, but the respective sentence in the article is clearer, specifying the cost to the NHS. Nevertheless, it fails to specify what "a month supply" comprises, and the US cost is then piggy-backed on this unkown quantity as "this amount". If q.100 is the nominal standard being used in all articles—I haven't checked other articles in this level of detail—then state it as such, not a vague "month supply". Or if it is based on an aggregate figure, specify that. Clearly in this case the "month supply" used in the US calculation is not a typical month's maintenance dose which is 2 to 5 times as much. --D Anthony Patriarche (talk) 21:31, 23 August 2019 (UTC)

Have 1) moved the details to the body of the article 2) added the specific dose it pertains to 3) added a couple of extra secondary sources 4) link the wholesale cost to the NADAC 5) stipulated that this is the generic version. Doc James (talk · contribs · email) 20:46, 14 April 2020 (UTC)

I guess the question is should we add goodrx? States price about $15 USD.[1] Doc James (talk · contribs · email) 21:05, 14 April 2020 (UTC)

NADAC is the price pharmacies pay rather than the government by the way. Doc James (talk · contribs · email) 21:38, 14 April 2020 (UTC)

Remove it from the lead per applicable policies and RfCs as identified at WP:MEDMOS2020 and WP:PRICES.

The content in the article body needs to be reviewed and possibly rewritten for basic WP:V and OR violations to be sure we're not adding to the hundreds of such problems identified in MEDMOS2020.

The content in the article body needs review and possibly rewritten against basic WP:NOT and POV violations, again per MEDMOS2020. --Hipal/Ronz (talk) 21:30, 23 April 2020 (UTC)

Article too lean

A good deal of necessary pruning was done to this article ca. 2009. However, IMO, it's a bit too lean now. Although methocarbamol is not highly "notable" in terms of scientific papers or Google hits, it is certainly notable as a consumer product, with annual sales in the hundred millions and perhaps even billions of dollars worldwide; figures are hard to come by online, but in Germany alone Recordati Pharma GmbH reported sales of 34 million Euros in 2017 for methocarbamol as Ortoton (see http://www.recordati.com/resources/Pubblicazione/___eaf059e2c0ac4d518f80a0725831ce50_/260418_ar_rec_17_eng_web.pdf).

In particular, a short section on mechanism of action (however uncertain) and/or related drugs would be helpful. The article leader gives undue emphasis to the inhibition of carbonic anhydrase: the reference cited says "The inhibition by these drugs is not sufficiently strong to implicate CA I and II in their mechanism of action." There are now many copies of this doubtful assertion on the www without attribution, probably due to its prominence here and WP's reputation. Several other mechanisms have been suggested for the action of methocarbamol and its sister compounds mephenesin & meprobamate.

I propose to add the section and move the "carbonic anhydrase" reference out of the leader, where it is too prominent for its actual significance & reliability. --D Anthony Patriarche (talk) 04:03, 12 May 2018 (UTC)

Indeed, it seems to me that the pharmacology section was very cottaged and disorganized. AteneaZ3 (talk) 21:30, 13 August 2022 (UTC)

Cerebral palsy & other neuromuscular disorders

The lead says methocarbamol is not useful for cerebral palsy, with a drugs.com cite (ref name=AHFS2019) that in turn cites a 2004 handbook. However there is research indicating at least 50% success in treating CP in children, e.g. [2]

A good effect was noted, above all, on spastic diplegia, in which group half of the children experienced improvement. 
The beneficial effect on the lower limbs was statistically significant (P < 0.01)

Tertiary sources e.g. https://www.sciencedirect.com/topics/neuroscience/methocarbamol indicate at least some benefit in CP and other chronic dyskinesias. I have a distant memory of a forum for patients suffering from (iirc) M/D or M/G which had extensive discussion of the use of M——; https://www.medindia.net/drugs/medical-condition/musculardystrophy.htm lists it for M/D. I will do more digging to ensure reliable, up-to-date sources.

The drugs.com source cited for "less preferred" in low back pain doesn't actually say it is less preferred in the sense other drugs are chosen to the exclusion of methocarbamol; the wording is somewhat convoluted, but I interpret it as meaning an analgesic should be prescribed in addition to methocarbamol or other skeletal muscle relaxants. Other sources recommend it in acute low back pain, but indicate less useful in chronic LBP—an important distinction in my personal experience. It may have use in pain from other spinal nerve pinches, esp. cervical.

The tertiary source I mentioned above has cites for use in other conditions, e.e bruxism. Again, I will do some more digging. But (as always) feel free to preempt me, as I may not get a round tuit for a while! --D Anthony Patriarche (talk) 08:19, 30 July 2019 (UTC)

Sciencedirect is simple a search of their collection. Which book are you looking at? Doc James (talk · contribs · email) 20:47, 14 April 2020 (UTC)

WikiProject Medicine April 2020

Hello, I am DocWock, a rising PGY1 in an american residency, and I would like to work on this page for wikiproject medicine. I will be following the manual of style on the wikiproject medicine page. My primary focus is medical uses, contraindications, and adverse effects of the medication. I will be attempt to use on systematic reviews and meta-analyses as sources for the material. The article needs more reputable sources as well as more up to date sources. I am unfamiliar with working on a medication page but will do my best to highlight the practical within the possible, as most drugs seem to have an infinite number of adverse effects. I will be working on the following sections:

Medical uses:
- Create section; if possible, discuss its use in traumatic injury, chronic pain, rheumatoid arthritis, and cerebral palsy

Adverse Effects:
- expand on current knowledge, bring up to date sources, change language and format for readability

Contraindications:
- create if possible, may be redundant with adverse effects e.g. "causes liver toxicity" and "avoid in liver failure"

Pharmacology:
- mechanism of action seems to be essential to the understanding of a medication, will create if fully understood by researches

Chemisty/Manufacturing
- outside of my scope

DocWock (talk) 02:52, 17 April 2020 (UTC)

Sounds good User:DocWock Welcome. Doc James (talk · contribs · email) 02:22, 18 April 2020 (UTC)

Update

I believe that the bulk of the work has been completed. There are minimal secondary and tertiary sources in recent years that discuss methocarbamol individually when describing muscle relaxants and even less that compare the effects to the other more well-studied muscle relaxants, such as cyclobenzaprine. I believe that the medical uses section is appropriately describing the inconsistency and limitations in the current research. When going through the tertiary sources from sciencedirect.com, there were very few that added new information that was applicable to the article. The research section will likely need to be revisited as primary sources build into secondary ones in the coming years. Please direct any questions you may have about my work to my talk page.

Thank you.DocWock (talk) 16:26, 19 April 2020 (UTC)

FDA Labels

There are now two FDA drug labels as sources for the medication. One is for the tablet formulation and the other for the inject-able formulation. I would argue that there are unique differences between the two. For example an injectable might have injection site reactions (or extravasation) or issues with too rapid of an infusion. The tablet could lead to some GI irritability or might affect the absorption of another medication. However, the article does seem to use it in that way consistently and instead occasionally cites both sources for common information between the two and at other times only uses one source. For example, the treatment of tetanus is unique to the injectable (and is cited properly) while both will have similarly affect pyridostigmine bromide (both are cited) and myasthenia gravis (only injectable is cited for affecting myasthenia gravis).

Is there a precedent for this we can follow or should we decide to cite both for all of the information obtained from either?

DocWock (talk) 02:04, 20 April 2020 (UTC)

References

Pharmacology section

This Pharmacology section needs to be reorganized. It is incorrectly classified. To begin with, it should go at the beginning, before side effects and interactions. In addition, it should be classified in pharmacokinetics and pharmacodynamics, as it is correct. Remember that the metabolism of a drug is part of its pharmacokinetics. AteneaZ3 (talk) 21:28, 13 August 2022 (UTC)

Is Methocarbamol (Anti)cholinergic?

I know that the mechanism of action hasn't been fully elucidated. But there is information on this page that points to sources saying either that the drug has anticholinergic activity, or is potentially an acetycholinesterase inhibitor. The sources cited do state this, but I can't find any actual studies or data to support either one. The closest thing I can find is an article from the 60's where a patient presented with exacerbated myasthia gravis symptoms after taking methocarbamol with her pyridostigimine. Surely this can't be the only evidence of that interaction. (even if it is, a case report doesn't do much in the way of explaining). I'm going to dig a little deeper to try to add some info to the pharmacology/mechanism of action research. Ratharax (talk) 16:43, 17 April 2023 (UTC)ratharax